History of EBAA and Eye Banking
When the Eye Bank Association of America (EBAA) was founded in 1961, eye banking had already been practiced for more than half a century. The first successful full thickness cornea transplant was performed by Dr. Eduard Zirm in 1905 in Austria. Over the past 115 years, cornea donation, eye banking, and cornea transplantation have evolved immensely with EBAA members providing tissue for over 2 million life-enhancing transplants.
Use the interactive timeline below to view the various milestones in eye banking and EBAA over the years.
Conceptualization of EBAA
Under the auspices of the American Academy of Ophthalmology and Otolaryngology (AAO&O), a group of eye bankers, physicians and medical groups begin discussions about establishing a distinct organization for eye banking.
AAO&O Committee forms the Eye-Bank Association of America (EBAA).
AAO&O Committee forms the Eye-Bank Association of America (EBAA)
The AAO&O’s convened and created an association which they named the Eye-Bank Association of America. It was decided that the EBAA would be governed by a Board of Directors and House of Delegates, with the AAO&O Committee of Eye Banks serving as its Medical Advisory Committee. From a start of 38 founding eye banks, our membership today stretches into Canada, Puerto Rico, and around the world.
The first report of eye banking activity was published in 1962, reporting that 2,000 corneal transplants were performed in 1961. Data was collected every five years through 1976, and annually thereafter.
Early reports detailed the sources and uses of eye and corneal donations, and offered an analysis of trends within eye banking. They included the number of individuals on the transplant wait list at the end of the year, with an average 1-2 month waiting time in North America.
These early reports included the total number of donations not used for medical / safety reasons, rather than the detailed analysis of contraindications seen today. Over the years, we have stratified the data by type of keratoplasty, the surgical intentions for transplant, and other characteristics, and maintain separate statistics for corneas provided for use outside the United States.
In 2011, we launched EBAA Connect, a real-time web-based statistical reporting and analysis program for our members to provide their monthly their data monthly. In 2021, we will replace EBAA Connect with our new EBAA Statistical Information System, E-StatIS, which offers a more intuitive user interface and enhanced analytics and benchmarking capabilities.
CEBT Certification and EBAA Accreditation Program Established
Immediately following the introduction of EBAA’s medical standards, the association established an eye bank accreditation program to ensure compliance with the Standards. More than 40 years later, our accreditation program remains the gold standard in supervision of eye banking processes.
The certified eye bank technician (CEBT) certification was also created in 1981, to enhance the skills, knowledge and professionalism of eye bank technicians and leaders.
Advances in Tissue Preservation
The most significant barrier to increasing the number of corneal transplants was the limited ability to preserve tissue after recovery. These obstacles were largely overcome when Herbert E Kaufman, MD, et. al. introduced the k-sol preservation medium, which preserved tissue for up to seven days under refrigeration. At the same time, Donald Doughman, MD, developed the organ culture technique, which allows for up to 33-day storage at room temperature.
Adverse Reaction Reporting
EBAA instituted an adverse reaction reporting system to allow eye bankers and physicians to study, understand and resolve the causes of adverse reactions in transplanted corneas. The written system was replaced by an online version in 2004. EBAA-member eye banks are required to seek post-operative reports from surgeons for every cornea they place, and these reports are discussed at every Medical Advisory Board meeting.
The Mary Jane O’Neill Fellowship for International Eye Banking is established.
Established in honor of Mary Jane O’Neill, EBAA’s long-time executive director, this fellowship funds one international eye bank professional to travel to the U.S., attend the EBAA annual meeting and ‘spend two weeks observing operations at an EBAA-host eye bank.
Endothelial Keratoplasty Surgeries Performed / Povidone-Iodine Required to be Used
First endothelial keratoplasty surgeries are performed; these transplants use only one layer of corneal tissue, rather than the entire cornea. This reduces recovery time and the risk of post-surgical complications. Today, ultra-thin EK tissue prepared by EBAA-member eye banks can be a little as 25 microns thick – one-quarter the thickness of a human hair.
Povidone-iodine kills fungus, viruses and other foreign bodies on donor tissue; its application has been required by EBAA’s Medical Standards since 2005. Eye banks continue to use povidone-iodine during tissue recovery; it is known to kill the COVID-19 virus.
Uniform Anatomical Gift Act is a Federal Code that directs state legislation and regulations regarding organ, eye and tissue donation. This revision significantly increased the number of donors accessible by reaffirming that donation is an individual’s decision, and that family members cannot overrule the donor’s wishes. This resulted in tens of thousands more life-saving organs and hundreds of thousands more corneas and tissues.
CMS Revises Medicare Reimbursement
All EBAA-member eye banks are non-profit organizations, and almost all exclusively provide corneal tissue. When Medicare reimbursement policy was revised to reimburse eye banks 100% of their direct cost to recover, process and deliver corneal tissue, waiting lists for corneal transplants were quickly cleared and have never returned. This is because eye banks could focus their efforts on tissue recovery and processing without needing to conduct fundraising effort to keep their doors open.
To this day, EBAA-member eye banks do not profit from donors; any surplus funds are returned to their operational budget or used to provide free or reduced-fee tissue to financially-challenged patients.
The Physician Leadership Program is established.
Recognizing that EBAA and the profession would benefit by engaging corneal surgeons as soon as they started in practice, EBAA established its Physician Leadership Program to introduce younger surgeons to eye banking. Attendees engage in a two-day program led by seasoned eye bankers and physicians who share all elements of the eye banking process. Program topics include tissue donor evaluation, tissue recovery and processing, as well as personal leadership and career development.
High Impact Grant, Injected Endothelial Cells, and First 3D Cornea
EBAA releases the High Impact Research grant to fund research at a higher amount.
First round of human trials of injected endothelial cells
Researchers in the UK release first 3D printed artificial cornea
2 Million Transplant Milestone Reached
Sometime in September 2019, the two-millionth cornea provided by and EBAA-member eye bank was transplanted, restoring sight and transforming the life of a grateful recipient. We are humbled by the impact our work has on the people we’re able to serve.
2021 and Beyond
2021 and Beyond
EBAA will continue to support our members as we continue to lead, innovate, and strengthen the eye banking, cornea donation, and cornea transplantation professions.
EBAA is constantly developing services, educational programs, resources, and more to better serve our members. In 2021, EBAA is celebrating 60 years of leadership and innovation in the field of eye banking and sight restoration. Take a closer look at some of EBAA’s milestones on the EBAA Anniversary page.